Original Article
  

The Efficacy of Budesonide-formoterol in Patients with Acute Attacks of Mild-to-moderate Bronchial Asthma: An Observational Study

Abstract

To assess the impact of budesonide-formoterol on pulmonary ventilation function and prognosis in patients with mild-to-moderate acute exacerbations of bronchial asthma.
A retrospective analysis was conducted on clinical data from 232 patients with acute exacerbations of bronchial asthma. These patients were divided into 2 groups based on their treatment: a control group (n=104) receiving budesonide dry powder inhalation and an observation group (n=107) receiving budesonide-formoterol dry powder inhalation. Clinical efficacy and safety indicators were compared.
The results showed that the total treatment effectiveness rate in the observation group was significantly higher than that in the control group. Following treatment, the observation group exhibited significantly higher scores in the Asthma Quality of Life Questionnaire (AQLQ), as well as improved levels of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF), compared to the control group. Moreover, levels of tumor necrosis factor-alpha, interleukin-6, and C-reactive protein were significantly lower in the observation group. The incidence of adverse reactions between groups was comparable.
Based on these findings, the application of budesonide-formoterol demonstrated significant effectiveness in patients with mild-to-moderate acute exacerbations of bronchial asthma. The combination therapy led to improved clinical outcomes, including enhanced pulmonary ventilation function and reduced inflammatory markers. Importantly, the safety profile of budesonide-formoterol was comparable to that of budesonide monotherapy. These results highlight the potential benefits of using budesonide-formoterol as an alternative treatment option for patients experiencing acute exacerbations of mild-to-moderate bronchial asthma.

1.Chetta A, Calzetta L. Bronchial asthma: an update. Minerva Med. 2022;113(1):1-3.
2. Ramsahai JM, Hansbro PM, Wark PAB. Mechanisms and Management of Asthma Exacerbations. Am J Respir Crit Care Med. 2019;199(4):423-32.
3. Moraes LHA, Coelho RMD, Neves Dos Santos Beozzo GP, Yoshida RAM, de Albuquerque Diniz EM, de Carvalho WB. Use of budesonide associated with a pulmonary surfactant to prevent bronchopulmonary dysplasia in premature newborns - A systematic review. J Pediatr. 2023;99(2):105-11.
4. Beasley R, Holliday M, Reddel HK, Braithwaite I, Ebmeier S, Hancox RJ, et al. Controlled Trial of Budesonide-Formoterol as Needed for Mild Asthma. N Engl J Med. 2019;380(21):2020-30.
5. O'Byrne PM, FitzGerald JM, Bateman ED, Barnes PJ, Zhong N, Keen C, et al. Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma. N Engl J Med. 2018;378(20):1865-76.
6. Effects of treatment with montelukast alone, budesonide/formoterol alone and a combination of both in cough variant asthma. Respir Res. 2022;23(1):279.
7. Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF Jr, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update from the National Asthma Education and Prevention Program. JAMA. 2020;324(22):2301-17.
8. Reddel HK, Bacharier LB, Bateman ED, Brightling CE, Brusselle GG, Buhl R, et al. Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes. Eur Respir J. 2021;59(1):2102730.
9. Crossman-Barnes CJ, Sach T, Wilson A, Barton G. Estimating loss in quality of life associated with asthma-related crisis events (ESQUARE): a cohort, observational study. Health Qual Life Outcomes. 2019;17(1):58.
10. iu F, Liu YR, Liu L. Effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma: a systematic review. Zhongguo Dang Dai Er Ke Za Zhi. 2021;23(10):1050-7.
11. Chen F, Yu M, Zhong Y, Hua W, Huang H. The role of neutrophils in asthma. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2021;50(1):123-130.
12. Haile SR, Guerra B, Soriano JB, Puhan MA; 3CIA collaboration. Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores. BMC Med Res Methodol. 2017;17(1):172.
13. Vandewalle J, Luypaert A, De Bosscher K, Libert C. Therapeutic Mechanisms of Glucocorticoids. Trends Endocrinol Metab. 2018;29(1):42-54.
14. Shimba A, Ikuta K. Control of immunity by glucocorticoids in health and disease. Semin Immunopathol. 2020;42(6):669-80.
15. Jorup C, Lythgoe D, Bisgaard H. Budesonide/formoterol maintenance and reliever therapy in adolescent patients with asthma. Eur Respir J. 2018;51(1):1701688.
16. Marghli S, Bouhamed C, Sghaier A, Chebbi N, Dlala I, Bettout S, et al. Nebulized budesonide combined with systemic corticosteroid vs systemic corticosteroid alone in acute severe asthma managed in the emergency department: a randomized controlled trial. BMC Emerg Med. 2022;22(1):134.
17. Ruihong Z, Lu W, Xiaoli L. Effect of terbutaline combined with budesonide in treatment of bronchial asthma and rehabilitation nursing. Pak J Pharm Sci. 2018;31(5(Special)):2249-55.
18. Daley-Yates P, Brealey N, Thomas S, Austin D, Shabbir S, Harrison T, et al. Therapeutic index of inhaled corticosteroids in asthma: A dose-response comparison on airway hyperresponsiveness and adrenal axis suppression. Br J Clin Pharmacol. 2021;87(2):483-93.
19. Mandlik DS, Mandlik SK. New perspectives in bronchial asthma: pathological, immunological alterations, biological targets, and pharmacotherapy. Immunopharmacol Immunotoxicol. 2020;42(6):521-44.
20. Beasley R, Harrison T, Peterson S, Gustafson P, Hamblin A, Bengtsson T, et al. Evaluation of Budesonide-Formoterol for Maintenance and Reliever Therapy Among Patients with Poorly Controlled Asthma: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(3):e220615.
21. Reddel HK, O'Byrne PM, FitzGerald JM, Barnes PJ, Zheng J, Ivanov S, et al. Efficacy and Safety of As-Needed Budesonide-Formoterol in Adolescents with Mild Asthma. J Allergy Clin Immunol Pract. 2021;9(8):3069-3077.e6.
22. Muiser S, Imkamp K, Seigers D, Halbersma NJ, Vonk JM, Luijk BHD, et al. Budesonide/formoterol maintenance and reliever therapy versus fluticasone/salmeterol fixed-dose treatment in patients with COPD. Thorax. 2023;78(5):451-8.
23. Bateman ED, Reddel HK, O'Byrne PM, Barnes PJ, Zhong N, Keen C, et al. As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. N Engl J Med. 2018;378(20):1877-87.
24. Sobieraj DM, Weeda ER, Nguyen E, Coleman CI, White CM, Lazarus SC, et al. Association of Inhaled Corticosteroids and Long-Acting β-Agonists as Controller and Quick Relief Therapy with Exacerbations and Symptom Control in Persistent Asthma: A Systematic Review and Meta-analysis. JAMA. 2018;319(14):1485-96.
Files
IssueVol 23 No 4 (2024) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijaai.v23i4.16210
Keywords
Acute Exacerbation Bronchial asthma Budesonide Combination therapy Formoterol Pulmonary ventilation function Treatment efficacy
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Li Y, Zeng W, Lu Q, Yin W, Huang S, Wei H, Liao L, Zhong J, Qin X. The Efficacy of Budesonide-formoterol in Patients with Acute Attacks of Mild-to-moderate Bronchial Asthma: An Observational Study. Iran J Allergy Asthma Immunol. 2024;23(4):357-365.